Tweaking labour policies for maternal friendly workplaces

• Breastfeeding Protects Infants From Childhood Illnesses — Experts
As World Breastfeeding Week is observed, medical experts have urged mothers to breastfeed their babies, as breast milk provides infants with needed nutrients.

The World Health Organisation (WHO) recommends exclusive breastfeeding, starting within one hour after birth until a baby is six months old. Nutritious complementary foods should then be added, while continuing to breastfeed for up to two years or beyond.

However, statistics have shown that three in five babies are not well breastfed in the first hour of life, though breastfeeding within this period is critical for saving newborn’s lives.

According to WHO, under-nutrition is associated with 2.7 million child deaths yearly or 45 per cent of all child deaths. The body said infant and young child feeding is a key area to improve child survival and promote healthy growth and development.

The first two years of a child’s life are particularly important, as optimal nutrition during this period lowers morbidity and mortality, reduces the risk of chronic disease, and fosters better development overall. Medical Experts said optimal breastfeeding is so critical that it could save the lives of over 820, 000 children under the age of five yearly.

Dr. Deji Akinola a Paedetrician at Lagos University Teaching Hospital (LUTH), said: “Breastfed children have higher intelligence, and not breastfeeding results in economic losses of about N302bn yearly. It is evident that breastfeeding is one of the best investments in saving lives and improving the health, social and economic development of individuals and nations.

“However, despite international recommendations, only 40 per cent of all babies under six months are exclusively breastfed and 45 per cent continue breastfeeding up to 24 months.

“Inequalities, such as gender discrimination and lack of support for parents at work stand in the way of sustainable development. Globally, a mother’s return to paid work after childbirth is one of the leading reasons for early cessation of breastfeeding. More than 830 million women workers do not have adequate maternity protection.

“It is also important to note that more than half, 61.2 per cent of the global workforce make their living in the informal economy and are not covered by maternity protection policies. Breastfeeding mothers in the informal economy face such additional barriers as living far from work, long working hours without breaks, and dangerous work environments.”

He noted that the challenges of paid work are exacerbated by the unequal distribution of care work, with the assumption of females as sole caregivers.

He said: “Furthermore, the International Labour Organisation (ILO) reports that only 78 out of the 170 countries studied offer paternity leave. Lack of paternity leave limits the time fathers can spend with their partners and children after birth. Additionally, child health and social services often ignore or exclude fathers and do not inform them about breastfeeding support. World Breastfeeding Week 2019 campaign aims to address labour and gender inequalities to protect, promote and support breastfeeding.

“Parental social protection measures include paid public-funded leave for both parents, flexible workplace policies that enable breastfeeding, as well as state-supported cash transfer programmes for parents and families. Policies and legislation that protect maternity rights, while allowing for a more equal distribution of the burden of care, are integral to achieving greater gender equality and empowerment.

“Parent-friendly workplaces in the formal sector should offer paid leave, a private space with facilities to breastfeed or express and store breast milk, affordable childcare within the workplace or nearby, along with flexible working hours to help mothers continue breastfeeding. In the informal sector, we should work to ensure that workers are recognised and protected by national laws that also support optimal breastfeeding.”

“Gender-equitable parenting that includes fathers/partners on the parenting team benefit both children and parents. Fathers/partners can learn co-parenting strategies for supporting breastfeeding that are sensitive to what the mother wants and needs. Couples need to agree on their breastfeeding goals and communicate well with each other, especially when there are challenges to breastfeeding.”

Senior lecturer and Consultant Public Health Physician Department of Community Health and Primary Health Care Lagos State University College of Medicine, Dr. Modupe Akinyinka said: “If breastfeeding were scaled up to near universal levels, about 820, 000 child lives would be saved every year. Breastfeeding protects infants. It is safe and contains antibodies that help protect infants from common childhood illnesses, such as diarrhoea and pneumonia, the two primary causes of child mortality worldwide. Breast milk is readily available and affordable, which helps to ensure that infants get adequate nutrition.”

“Breastfeeding also benefits mothers, as exclusive breastfeeding is associated with a natural, though not fail-safe method of birth control, about 98 per cent protection in the first six months after birth. It reduces risks of breast and ovarian cancer, type II diabetes, and postpartum depression.

“Breastfeeding has long-term benefits for children, as it contributes to a lifetime of good health. Adolescents and adults who were breastfed as babies are less likely to be overweight or obese. They are less likely to have type-II diabetes and perform better in intelligence tests.

“Infant formula does not contain the antibodies found in breast milk; the long-term benefits of breastfeeding for mothers and children cannot be replicated with infant formula. When infant formula is not properly prepared, there are risks arising from the use of unsafe water and unsterilised equipment or the potential presence of bacteria in powdered formula.

“Malnutrition can result from over-diluting formula to stretch supplies. Transmission of Human Immunodeficiency Virus (HIV) through breastfeeding can be reduced with drugs. An HIV infected mother can pass the infection to her infant during pregnancy, delivery and through breastfeeding. However, antiretroviral therapy (ARV) drugs given to either the mother or HIV-exposed infant reduces the risk of transmission.

“Together, breastfeeding and ARVs have the potential to significantly improve infants’ chances of surviving, while remaining HIV uninfected. WHO recommends that when HIV-infected mothers breastfeed, they should receive ARVs and follow WHO’s guidance for infant feeding.”

Akinyinka explained that marketing of breast-milk substitutes should be highly monitored, and that an international code to regulate the marketing of breast-milk substitutes was adopted in 1981.

“It calls for all formula labels and information to state the benefits of breastfeeding and the health risks of substitutes, no promotion of breast-milk substitutes, no free samples of substitutes to be given to pregnant women, mothers or their families; and no distribution of free or subsidised substitutes to health workers or facilities.

She noted that support for mothers was essential, as breastfeeding has to be learned and many women encounter difficulties at the beginning.

She said: “Many routine practices, such as separation of mother and baby, use of newborn nurseries, and supplementation with infant formula, actually make it harder for mothers and babies to breastfeed.

Health facilities that support breastfeeding by avoiding these practices and providing trained breastfeeding counsellors for new mothers encourage higher rates of the practice. To provide this support and improve care for mothers and newborns, most countries have implemented the WHO-UNICEF Baby friendly hospital initiative, which sets standards for quality care.

“Skin-to-skin contact, along with suckling at the breast stimulates the mother’s production of breast milk, including colostrum, also called the baby’s ‘first vaccine’, which is extremely rich in nutrients and antibodies.”

Henrietta H. Fore, UNICEF Executive Director emphasised the need for timing in a recent report.

She said: “In many countries, timing can even be a matter of life and death. Yet each year, millions of newborns miss out on the benefits of early breastfeeding and the reasons – all too often – are things we can change. Mothers simply don’t receive enough support to breastfeed within those crucial minutes after birth, even from medical personnel at health facilities.”

“Breastfeeding rates within the first hour after birth are highest in Eastern and Southern Africa (65 percent) and lowest in East Asia and the Pacific (32 percent), the report says. Nearly nine in 10 babies born in Burundi, Sri Lanka and Vanuatu are breastfed within the first hour. By contrast, only two in 10 babies born in Azerbaijan, Chad and Montenegro do so”.